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Digestive Diseases and Sciences
Published in: Digestive Diseases and Sciences 7/2022

24-06-2021 | Hepatic Encephalopathy | Review

Pre-procedural Preparation and Sedation for Gastrointestinal Endoscopy in Patients with Advanced Liver Disease

Authors: Brian M. Fung, Deanna J. Leon, Lauren N. Beck, James H. Tabibian

Published in: Digestive Diseases and Sciences | Issue 7/2022

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Abstract

Gastrointestinal endoscopy in patients with advanced liver disease poses various challenges, a major one being procedural sedation and its associated considerations. While sedation during endoscopy can improve patient comfort, decrease anxiety, and facilitate procedural completion, in patients with advanced liver disease, it is also associated with substantial and unique risks due to alterations in drug metabolism and other factors. As such, the choice of sedative agent(s) and related logistics may require careful inter-disciplinary planning and individualized considerations. Furthermore, a large proportion of agents require dose reductions and particular monitoring of the vital signs, level of consciousness, and other indices. In the present review, we provide a contemporary overview of procedural sedation considerations, commonly used intravenous sedatives, and second-line as well as novel sedatives for gastrointestinal endoscopy in patients with advanced liver disease.
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Metadata
Title
Pre-procedural Preparation and Sedation for Gastrointestinal Endoscopy in Patients with Advanced Liver Disease
Authors
Brian M. Fung
Deanna J. Leon
Lauren N. Beck
James H. Tabibian
Publication date
24-06-2021

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